Efficacy of smartphone- and bibliotherapy-delivered multicomponent lifestyle medicine interventions for probable depression: A three-arm randomized controlled trial.

Chung-Yan Chow; Vincent Wing-Hei Wong; Fiona Yan-Yee Ho

doi:10.1016/j.jad.2026.122319

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Efficacy of smartphone- and bibliotherapy-delivered multicomponent lifestyle medicine interventions for probable depression: A three-arm randomized controlled trial.

Chung-Yan Chow·Vincent Wing-Hei Wong·Fiona Yan-Yee Ho

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Abstract

BACKGROUND: This study examined the efficacy of smartphone- (AG) and bibliotherapy-delivered (BG) lifestyle medicine (LM) interventions compared with a waitlist control group (WLG) in reducing depressive symptoms. METHODS: A total of 122 adults with probable depression were randomized to AG (n = 41), BG (n = 40), or WLG (n = 41). AG and BG received the same core 8-week multicomponent LM intervention via a smartphone application or booklets, respectively. The core content included lifestyle psychoeducation, physical activity, diet and nutrition, stress and sleep management, goal-setting, and motivational techniques. Outcomes were assessed at baseline and immediate post-intervention (Week 9) in all groups, with 1-month (Week 13) and 3-month (Week 21) follow-ups conducted in the intervention groups only. RESULTS: At Week 9, AG (d = 0.89) and BG (d = 0.64) showed significantly greater reductions in depressive symptoms than WLG, with within-group improvements maintained at 1- and 3-month follow-ups (ps <.001, d = 0.77-0.96). Clinically significant improvement was achieved by 78% of AG and 55% of BG participants, both significantly higher than WLG (19.5%; ps <.001). Compared with WLG, both interventions yielded greater improvements in overall lifestyle and physical activity (d = 0.59-0.91) at Week 9. The AG showed additional benefits for perceived stress, health responsibility, nutrition, spiritual growth, and stress management (d = 0.58-0.73), whereas BG uniquely improved insomnia symptoms (d = 0.83). CONCLUSION: Smartphone- and bibliotherapy-delivered LM interventions are efficacious for managing probable depression. Further RCTs comparing them with established treatments are warranted.

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Humans Bibliotherapy Female Smartphone Life Style Male Middle Aged Depression Treatment Outcome Adult Lifestyle medicine Randomized controlled trial Self-help Journal Article Randomized Controlled Trial

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Chung-Yan Chow, Vincent Wing-Hei Wong, Fiona Yan-Yee Ho. 2026-07-26. Efficacy of smartphone- and bibliotherapy-delivered multicomponent lifestyle medicine interventions for probable depression: A three-arm randomized controlled trial.. https://doi.org/10.1016/j.jad.2026.122319

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Journal Article; Randomized Controlled Trial resource Adult subject Bibliotherapy subject Depression subject Female subject Humans subject Journal Article subject Life Style subject Lifestyle medicine subject Male subject Middle Aged subject Randomized controlled trials study

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